title: Long-term clinical outcome and routine angiographic follow-up after successful recanalization of complex coronary true chronic total occlusion with a long stent length: a single-center experience.
abstract: OBJECTIVE
  To evaluate clinical and angiographic outcomes after successful recanalization of chronic total coronary occlusion (CTO) with implantation of a long total stent length (SL).
  
  
  BACKGROUND
  Routine follow-up angiogram (RFUA) data after successful recanalization of CTO with a long SL are lacking.
  
  
  METHODS
  RFUAs were performed at 6 months after successful recanalization of 106 CTOs using drug-eluting stents (DESs) with a long SL (≥ 20 mm) in 102 consecutive patients.
  
  
  RESULTS
  Mean number of stents was 3.9 ± 1.8 and mean total SL was 78 ± 32 mm (range, 23-174 mm). Sirolimus-eluting stents (SESs) were used in 100 lesions. In-stent total reocclusion occurred in 2 cases (1 SES and 1 non-SES DES). Restenosis rate was 18% in the 100 SES subgroup (total SL, 79 ± 33 mm; range, 23-174 mm; mean number of stents, 3.9 ± 1.8); younger age and longer total SL were found to be independent predictors of restenosis (longer age: hazard ratio, 0.939; 95% confidence interval, 0.885-0.996; P=.035; longer total SL: hazard ratio, 1.017; 95% confidence interval, 1.00-1.03; P=.045). Restenosis type was diffuse in only 11% and 89% were successfully treated by repeat percutaneous coronary intervention. During a median follow-up of 2 years (interquartile range, 1-4.3 years), major cardiac events other than those angiographically driven at RFUA occurred in 2 patients.
  
  
  CONCLUSIONS
  Angiographic restenosis rate remains acceptable in patients with complex CTO successfully treated by DES despite a long SL.
authors.affiliation: Division of Cardiology, University of Saint Etienne, Saint Etienne, France. isaaz@univ-st-etienne.fr
authors.forename: Karl
authors.initials: K
authors.lastname: Isaaz
authors.forename: Norbert
authors.initials: N
authors.lastname: Mayaud
authors.forename: Antoine
authors.initials: A
authors.lastname: Gerbay
authors.forename: Mohamed Hassan
authors.initials: MH
authors.lastname: Sabry
authors.forename: Laure
authors.initials: L
authors.lastname: Richard
authors.forename: Alexis
authors.initials: A
authors.lastname: Cerisier
authors.forename: Michel
authors.initials: M
authors.lastname: Lamaud
authors.forename: Hazem
authors.initials: H
authors.lastname: Khamis
authors.forename: Ahmad
authors.initials: A
authors.lastname: Abd-Alaziz
authors.forename: Antoine
authors.initials: A
authors.lastname: Da Costa
mesh_terms: D000368:Aged; D002908:Chronic Disease; D017023:Coronary Angiography; D054059:Coronary Occlusion / Q000000981:diagnostic imaging / Q000628:therapy*; D023903:Coronary Restenosis / Q000453:epidemiology; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D062645:Percutaneous Coronary Intervention / Q000295:instrumentation* / Q000379:methods*; D012189:Retrospective Studies; D020123:Sirolimus; D016896:Treatment Outcome
chemical_list: D020123:Sirolimus